WolfmanHarris

Seriously, do yourself a favour; wait. Give yourself a year minimum in the field, maybe even two to gain some perspective. You can dump a tonne of money into this stuff unnecessarily. Truly consider how you can best help someone off-duty and you'll realize the most useful things you can provide are a good 911 call, a calm presence, a blanket and nothing more complicated than you'd find in the average first aid kit.

Little trick I came up with for cargo pockets, use one of them to dispose of all your clean garbage during a call (electrode backing, O2 wrapper, etc.) that way you're not leaving the person's house a mess with your leftovers on top of whatever else they're going through.

Hey if you happened to treat a hammered Canadian, muttering something about being a Paramedic, let me know. A guy from my platoon was there.

Don't get hung up on buying equipment or the great stethoscope debate. Learn your priorities now and it'll help prevent burn-out. Priority one: yourself. Long before you go nuts with gear for scenes and patient care, consider your working environment and how to make the best of it. Look at your boots, socks, underwear; are they going to keep you comfortable and dry during the shift? Beyond that, get a good water bottle and keep it filled. Pick some healthy snacks for the truck and if you don't have a station where you can cook, make sure you get in the habit of packing a good lunch now before you start hitting the junk while on the road. If you don't have a base, toss a good neck pillow in your bag to help you rest in the truck when you can. Pack reading materials, some work related to keep current, and others just for fun so you can relax. Consider an ipod or portable dvd player. Toss some advil or aleve in your bag along with non-drowsy cough/cold medication for the aches and pains. You also can't go wrong with some travel toiletries (your partners will thank you for reapplying deodorant when necessary). Once you've done all that, then maybe look at a stethoscope that'll suit your needs and any other toys that will let you enjoy the new eager phase. Don't be put off by those that would call it being a "whacker"; as long as it's within reason, this is just the natural enthusiasm of a new job. Though do yourself a favour, no EMS tatoos until you're at least 15 years in.

I've always felt that relying on the words "TRAINER" in big and "Not for Patient Use" in small on an exactly the same shape/colour case is an unecessary risk. There would be no detriment to quality training for the AED trainer and it's case and accessories to be an entirely different colour (say hot pink). For example, the volunteer first response agency I recently taught had managed to place a Medtronic CR+ trainer in the extra case for their actual CR+. Given their response model there is little chance of them getting confused by a team member, but the point is well taken; this is a possible room for error. Just like we attempt to identify issues that set us up for failure in our practice (i.e. similarly packaged medication, commonly confused words) we should be ensuring training, or out of service equipment cannot be confused for front line equipment. If I can go off on a tangent with regards to public access AED's, I think the time has come to determine some best practices and consensus for design and operation of public access AED's. In teaching to the public I have utilized probably a half dozen different AED designs and while all were easy to use, I can certainly see how their small difference would confound a lay person on their first cardiac arrest. It reminds me of the past issues with ventilator errors that were corrected with standardization (or so I have read anyways).

A few months ago we responded for a 46 y/o F c/o of sudden onset confusion. Arrived to be greeted by the Pt. and her boyfriend at the door. Pt. was alert and oriented, in no distress, had no obvious trauma and appeared in good health. Upon assessment it was found that the Pt. anterograde and retrograde amnesia of apparently just episodic memory. Pt. had good recollection of people and places, but seemed to have no clear memory of any previous events and repetitive questioning. Pt. had no physical complaints, vital signs all within normal limits for a healthy adult. Pt. reported no medications and previously good health. Both Pt. and boyfriend denied any drug or alcohol use and reported Pt. in good health in recent days. Symptoms had began approximately 15 minutes post-coital. Working diagnosis was possible CVA. Pt. did not meet stoke bypass directives but was still transported on a non-emergency basis to the local ED (also the regional stroke centre). Pt. offloaded with no changes from above assessment. Follow-up with ED staff two days later and found out that the Pt. had been diagnosed with transient global amnesia and released with full resolution of symptoms within 24 hours. It was an interesting case that had all of us (including the stroke Doc) scratching our heads and thinking CVA.

I just checked mine, 2nd October, 2005. Though I don't think I actively posted for the first few years and I still spend more time reading then posting

http://youtu.be/aNc7mZ05OcU

Any relevant reliable advice is going to come from a lawyer. That being said this approach boggles me a bit. It would never fly in Ontario. Here pregnant medics are moved into the office full time on light duty, the same way injured medics would be. Even the small county service where I live, which has limited support staff places pregnant staff on light duty. I can be 100% sure that this is a legal requirement but it is certainly practice throughout the province.

Based on the instructions that come with the device, yes. I can't think of a reason not. I'm curious though where your thinking was that lead to this.

We do a fair number of transfers from Emer back to the nursing home across the parking lot. On of our medics (who's been on the job since 1968) will regularly walk these Pt.'s home in a wheelchair so they can enjoy the walk.

Most of our transports are 15-20 minutes, a few are half an hour, but a couple of the rural stations have transport times of 45 minutes. The total call including scene time, transport, triage generally runs 90 minutes. These calls aren't generally problematic. In the event of boredom: do paperwork, make small talk, or if they want to rest let them sleep, dim the lights and enjoy the quiet yourself.

I've taught a COPD Pt. (rapidly developing into a new frequent flier) how to properly use her advair diskus and provided her a spacer for her aerosol MDI's. I've cleaned up the excrement of a lift assist Pt. to make sure they didn't try to clean it up themselves and then fall again or make them wait with that mess until home care came in later that day. We also have access to a Community Referral by EMS program. We call the Community Care Access Centre (CCAC) which is a government service that provides access to various health resources. We provide them with information about the call, the Pt's chronic issues or situation and the help we think they may need and they're assigned a Case Manager social worker who attends the Pt.'s residence and gets them resources they may need. I use that fairly regularly for various Pt.'s including those needing post-incident care, frequent fliers, fall risks, failure to thrive, nutrition issues, smoking cessation (for COPD'ers). It's a great program and allows us to do more than repeatedly transfer the same Pt. for their chronic condition. They may need the transport, but there are better options than ED.

Agreed. All our vehicles have an anti-theft system that allows the vehicle to idle with the keys removed. I can see it getting more difficult if you don't have that feature and need to worry about climate control on scene, but then a simple fix is two sets of keys (good idea anyways) so that it can be locked with one set in and running and the other set of keys with the crew.

Should we PM answers?

That's hilarious. Easier to take a bunch of FF's and put them through two years of school with an average attrition rate of 40-50% or have a bunch of medics go to 12 week fire school. Fuck my life. So sick of this shit.

Why aren't more vehicles equipped with an anti-theft system. Any truck at my service or any other Ontario service I've dealt with, when you put the truck in park, engage the parking brake and flick the anti-theft switch the keys can be removed and the truck locked while keeping it running. Can't be put into gear at this point, just shuts off and since every vehicle has a key fob now, no real inconvenience to get back in.

The Lifesaving Society NLS (National Lifeguard Service) course for Pool and Waterfront options is 40 hours, usually taught over two weekends or one single week. It includes no organic first aid component and participants must have a Standard First Aid course as a prerequisite. I don't teach the surf option, nor is it available in my area, but I don't imagine it has a huge jump. From what I understand participants will often go south for a couple weeks, do the course and have a vacation. Not sure about Red Cross or other similar programs, but they're probably similar. This isn't an uncommon attitude though. I've seen it both with Lifeguards and First Responders that I have taught; the inflated sense of training and ego with a minimal to no understanding of what they don't know. It's a reason why I add a section on continuum of care and levels of education into most of my course, just to provide a tiny bit of context and show the participants where they fit in the chain.

At work: Belt: iphone leatherman Juice multitool big shears radio clip Shirt pockets: ear buds notepad and pen tim hortons gift card (just in case) Contact/comment cards (issued by work) Little clip on flashlight (nice and flat hides under my pocket flap) Pant pockets: Service reference book (directives, contact info, etc) Drug book Littman cardiology 3 I keep stuff on my belt so that I can toss the outer duty belt on the truck seat or over the mirror between calls and not be encumbered when I'm trying to sleep. Off duty: Wallet Phone Keys Badge (ministry ID and service badge) Sunglasses I do have some gloves and probably some gauze and an emerg blanket in the emergency kit in my car. But that's shoved in with the jumper cables and various roadside crud.

And this is why I both love and hate teaching the National Lifeguard Service course. Love it because I can teach from a position of greater understanding and experience in the field (7 years as a lifeguard prior to Paramedic school). Hate it because there's a butt load of rescue rickies teaching the same course turning out these NLS guards with delusions of grandeur.

You might find it easier to go cordura. You can probably find someone to custom one for you. The guy at my local surplus/camping/paintball store got a holster custom made for my Tiberus T9 pb pistol (needed a lefty). A rigger friend of his (he's retired CF) made it up and the final product cost less than my buddy's holster it was based on. My only remaining problem with big shears if where to keep them on my belt. So far only the small of my back seems to work ok.

Given the extremely high demand for the program, and prerequisites that include a letter of reference from your Base Hospital, I'd be surprised if they'd accept someone not currently practicing in Ontario. Only real way to know is to contact them and ask.

Red flag 1: "the answer key says..." Sure I've had to use pre-written exams for the first responder and EMR programs when I teach, but I do the test myself first, check the answer key for problems and then still allow for discussion. Multiple choice testing is for ease of marking not necessarily because it provides a good test of a students understanding.

I've got big shears. (gift from my wife) They're phenomenal shears but the title is apt; they're HUGE!

Good videos, but who the heck is "anti child restraint?" Certainly there's some bad practices out there, but I haven't seen a single person in this thread come out flippantly or seriously against.